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Sununu calls on lawmakers to fund $26M secure psychiatric hospital

CONCORD — The emergency room at Concord Hospital is a focal point in the state’s struggle to create enough psychiatric beds to meet the growing demand for mental health services.

Like other emergency rooms across the state, Concord’s is housing mental health patients awaiting space at nearby New Hampshire Hospital, the state’s psychiatric facility, sometimes for weeks at a time.

That’s why Gov. Chris Sununu chose the hospital on Tuesday to launch his counter-assault against House lawmakers and their plan to remove a $26 million secure psychiatric unit at New Hampshire Hospital from the governor’s proposed budget.

The new 60-bed forensic unit would have to be planned by November 2019 and operational by June 2021, according to the budget proposal Sununu submitted in February.

The new beds would accommodate patients with the most challenging mental health issues, including those now held at a secure psychiatric unit in the state prison, even though they’ve committed no crime.

The combined effect of the new building and investments in community-based mental health services would open up enough rooms at New Hampshire Hospital to end the emergency room boarding and accommodate the growing demand for mental health services, Sununu said.

Rare opportunity

Surrounded by supportive hospital officials, Republican lawmakers and commissioners from key state agencies, the governor on Tuesday urged the House and Senate to restore the funding. He cited the unusually large state budget surplus, fueled by a strong economy, as presenting a rare opportunity.

“We have $200 million in surplus funds; you don’t find that every day,” he said.

“That presents an opportunity for the state to not just talk about the issue, but make an impact. For 20 years we’ve been talking about designing a new secure psychiatric unit … I was appalled when I heard we might just kick that can down the road some more. We are here to advocate the need to move on this now, today.”

State Rep. Sharon Nordgren, D-Hanover, who chairs the Finance Committee division dealing with Health and Human Services, said on Monday it’s unusual for such a large building project to proceed without architectural, engineering or staffing plans in place, using a school building project as an example.

“This is a crisis that has never hit this state before,” he said. “So yes, are we taking drastic measures? You bet we are. Are they the right measures? Undoubtedly.”

Different perspective

Some community-based providers of mental health services are not so sure. They believe moving children and adults who no longer need to be at New Hampshire Hospital into community settings will open up all the space needed at the psychiatric facility to create a secure, forensic unit, without a $26 million construction project.

The Disability Rights Center, which sued the state over the treatment of mental health patients, supports the House action.

“We believe that building an unnecessary forensic hospital will divert precious funds and workforce from where they are most needed: community-based mental health services,” according to a DRC statement issued Tuesday.

“Spending millions of dollars to significantly expand the state’s mental health institutional bed capacity undermines the state’s ability to invest in much-needed sustainable changes to the state’s community mental health system. The House Finance Committee is making the right decision to not move forward with the governor’s proposal to build a forensic hospital.”

Finance Committee Chair Mary Jane Wallner, D-Concord, said the governor’s plan was unanimously voted down by members of both parties in the health and human services subcommittee, “because it was insufficient to address the mental health needs of our communities and proposed the construction of a building without any resources to staff or operate it.”

“The governor should work with us on lowering the need for new admissions in the first place, which we can accomplish through funding for community health efforts,” she said.

Focus on community

That sentiment was echoed by Becky Whitley, policy director for the N.H. Children’s Behavioral Health Collaborative.

“The collaborative undoubtedly shares the widespread concern about the large numbers of children, youth and adults waiting in hospital emergency departments for treatment,” she said.

“However, the best approach is to focus on building evidence-based and cost-effective community-based services designed to reduce the need for inpatient hospitalization, which tends to erode the community and family connections.”

State Rep. Renny Cushing, D-Hampton, has led the fight to move civilly committed patients out of the Secure Psychiatric Unit at the state prison for years.

Earlier this year he filed a bill to fund and construct such a facility, but agreed to have that bill amended to a study committee when he learned that Sununu would propose the use of surplus funds to build the unit in his state budget address.

“I’m disappointed that it’s not there in the budget that’s going to be recommended to the House, but I realize this is a long process,” said Cushing, “and I hope there’ll be a way to end the criminalization of people with mental illness.”

“We have $200 million in surplus funds; you don’t find that every day,” he said. “That presents an opportunity for the state to not just talk about the issue, but make an impact. For 20 years we’ve been talking about designing a new secure psychiatric unit … I was appalled when I heard we might just kick that can down the road some more. We are here to advocate the need to move on this now, today.”

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